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Minerva Chir ; 59(6): 573-82, 2004 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-15876991

RESUMO

The surgical treatment of liver metastasis due to colorectal cancer can substantially modify the natural history of the disease, mainly when it is associated with effective medical treatment. Chemotherapy, via systemic or locoregional (intrahepatic) administration, has 2 possible objectives: as adjuvant treatment, to prevent or delay disease recurrence; as neo-adjuvant treatment, mainly interesting for the surgeon, to allow resective surgery in responding patients previously considered not-operable. Unfortunately, the severe immune deficiency associated with the advanced cancer negative impact on long-term outcome after any treatment (surgery, chemotherapy) is a limit for the clinical application of multidisciplinary treatments. Aim of this study is to review the possible different approaches to improve the clinical results, either as tumour response or overall survival, using an association of IL-2 with different chemotherapy procedures, in order to recover the locoregional and/or systemic immunodeficency. Several literature studies are worth of consideration not only for the biological activity reported, but also for the preliminary clinical results. At our Department, we have started a clinical experience in order to verify and confirm the results reported in these studies. The preliminary results seem to confirm an increase of chemotherapy activity obtained with an association of IL-2 immunotherapy with systemic therapy procedures and mainly with locoregional therapeutic programs.


Assuntos
Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Antineoplásicos/uso terapêutico , Neoplasias do Colo , Imunoterapia , Interleucina-2/uso terapêutico , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/imunologia , Adenocarcinoma/mortalidade , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Terapia Combinada , Fluoruracila/administração & dosagem , Fluoruracila/uso terapêutico , Seguimentos , Artéria Hepática , Humanos , Infusões Intra-Arteriais , Injeções Subcutâneas , Interleucina-2/administração & dosagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/mortalidade , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
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